In the last 17 months, 22 cases of the rare STD lymphogranuloma venereum (LGV) have been diagnosed in Canada, the Public Health Agency of Canada (PHAC) reported Tuesday. Until recently, LGV was rare in developed nations, and Canadian public health officials said a case of the disease had not been diagnosed there in the 10 years prior to January 2004. PHAC officials declined to say in what part of the country LGV has been detected.

Those infected were mostly, if not all, gay and bisexual men in their 30s and 40s; most reported anal sex; a couple practiced "fisting"; one man reported taking crystal methamphetamine rectally; three-quarters were HIV co-infected; and a quarter were hepatitis C co-infected, said Tom Wong, director of community acquired infections at PHAC.

That LGV's lesions or ulcers can facilitate other STD infections concerns experts. "The issue of this infection and impact on both the HIV epidemic and the hepatitis C epidemic in the future is something that we all have to bear in mind from a clinical perspective and from a public health perspective," said Wong.

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Preventable and treatable if detected early enough, LGV is also not as transmissible as some other STDs, said Dr. Mark Tyndall, an infectious-disease specialist with British Columbia Center of Excellence in HIV/AIDS. "This is high risk activity that people are engaging in," said Tyndall. "This would select for men who are taking a lot of risk and would be a subset of the general gay men population."

Wong and colleagues detail their findings and the sexual behavior of those infected in the rapid report, "Emergence of Lymphogranuloma venereum in Canada," published in the Canadian Medical Association Journal (2005;172(13):1674-1676).

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